Leprosy, a chronic infectious disease that wreaks havoc on the skin and central nervous system, has become endemic (or regularly occurring) in Florida, according to the Centers for Disease Control and Prevention (CDC).
While leprosy is still relatively rare in the United States, accounting for around 200 cases nationwide, the number of cases has more than doubled in Southeastern states in recent years, according to a new CDC report on leprosy in central Florida. The state accounts for almost one-fifth of leprosy cases in the United States, and 81 percent of all cases in the state are in central Florida, including the Orlando metropolitan area, according to the CDC report.
How Is Leprosy Spread?
Traditionally, leprosy is spread through respiratory droplets exhaled by infected people or animals. Armadillos are a common source of the bacteria Mycobacterium leprae that causes these infections, according to the CDC. Historically, cases in the United States have often been traced to people who emigrated from or traveled extensively in countries where leprosy is more common, the CDC notes.
But a growing number of cases in the United States, and many of the cases in Florida, involve people born in this country who don’t appear to have any travel history or obvious exposure to armadillos, the CDC reported. For this reason, the CDC concludes that leprosy is now endemic in Florida, meaning that it’s a constant presence in the state — but that it’s also not spreading uncontrollably.
“I want to start off by noting that leprosy remains an incredibly uncommon illness in the United States that is highly treatable,” says Charles Dunn, MD, a coauthor of the CDC report and chief resident at the Kansas City University–Graduate Medical Education/Advanced Dermatology and Cosmetic Surgery Dermatology Residency program in Orlando.
What Are the Symptoms of Leprosy?
Telltale symptoms of leprosy can include rashes on the skin that have diminished sensation to touch, Dr. Dunn says. People can also experience numbness or tingling in the hands and feet, painless wounds or burns, lumps or swelling of the earlobes or face, and tender or enlarging nerves as the bacteria in the body slowly destroy nerves and muscles, Dunn adds.
Leprosy can be treated with antibiotics, but without treatment these infections can slowly destroy nerves and muscles, leading to thickening tissue in the face, loss of eyebrows and eyelashes, as well as striking deformities in the hands and feet, sometimes referred to as “claw hands” and “hammer toes,” Dunn says.
That’s why people should see a dermatologist as soon as they see any suspicious rashes, Dunn advises.
The report, published by the CDC in Emerging Infectious Diseases, detailed the case of a 54-year-old landscaper who came to the clinic with painful rashes on his extremities, trunk, and face. The man had lived in central Florida his entire life, and said he never traveled in the United States or internationally, and never had any exposure to immigrants from countries where leprosy is endemic or any contact with armadillos.
Doctors took biopsies of the man’s skin, which tested positive for leprosy, according to the case report. He was then treated successfully with antibiotics. However, doctors never determined how this patient got infected.
Sources of Leprosy Infections Often Go Unfound
“Admittedly, there are many people diagnosed with leprosy in which we don’t know the exact cause of illness,” Dunn says. “They have not traveled or lived anywhere other than Florida, they have no close contact with known cases, and they do not report exposure to armadillos.”
It’s particularly hard to pinpoint the source of leprosy cases like the one experienced by this patient and many others in central Florida because the bacteria grows very slowly once people are exposed, and it can take many years for people to develop clear symptoms, Dunn says.
“What we do know is that the armadillo population in Central Florida appears to carry strains of leprosy that are also causative of disease in humans,” Dunn adds. But it’s not always clear whether armadillos are the direct cause of spreading bacteria, if it lingers on soil or plants touched by infected armadillos, or whether other animals might also be able to transmit it to people, Dunn says.
Most People Are Immune to the Bacteria That Causes Leprosy
The vast majority of people worldwide, and in the United States, have innate immunity to the bacteria that cause leprosy, Dunn notes. Only about 5 percent of people are susceptible to leprosy, Dunn says. To get sick, people need to be exposed to the bacteria that causes leprosy over a long period of time.
“Contact with an infected armadillo is the most common way people acquire Mycobacterium leprae,” says Nicole Iovine, MD, PhD, a board-certified infectious disease physician and chief hospital epidemiologist at UF Health in Gainesville, Florida.
Bacteria that cause leprosy can spread to a person through physical contact with an infected armadillo or through aerosols generated when the animals are slaughtered, says Dr. Iovine, who wasn’t involved in the CDC report.
“Notably, simply passing by an armadillo that has been killed in the road is not an infectious risk,” Iovine says. “I would caution people against trying to intentionally trap or remove armadillos that they may see, because that could inadvertently cause an accidental exposure.”
Because most people aren’t susceptible to leprosy, and because it’s treatable with antibiotics, people shouldn’t panic or avoid travel to Florida, Dunn says.
This content was originally published here.
